Healthcare Provider Details

I. General information

NPI: 1053586453
Provider Name (Legal Business Name): MENTAL HEALTH RESOURCES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2008
Last Update Date: 04/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 GAMMON PL SUITE 290
MADISON WI
53719-1045
US

IV. Provider business mailing address

402 GAMMON PL SUITE 290
MADISON WI
53719-1045
US

V. Phone/Fax

Practice location:
  • Phone: 608-833-9779
  • Fax: 608-833-1197
Mailing address:
  • Phone: 608-833-9779
  • Fax: 608-833-1197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. SUSAN ANN BROWN
Title or Position: DIRECTOR AND PSYCHOTHERAPIST
Credential: PH.D, APNP
Phone: 608-833-9770